Granuloma inguinale

Last updated: December 30, 2022

Summarytoggle arrow icon

Granuloma inguinale is a sexually transmitted bacterial disease caused by Klebsiella granulomatis. It is seen most commonly in sexually active individuals between 20 and 40 years of age. Clinically, granuloma inguinale manifests with one or more genital nodules that develop into red, painless ulcers. The regional lymph nodes are typically spared. Diagnosis of granuloma inguinale is based primarily on clinical findings and is confirmed through detection of Donovan bodies (intracytoplasmic macrophages containing bacteria) in ulcer smears or biopsies. Management focuses on antibiotic treatment with azithromycin, which is continued until the ulcers have completely healed. Surgical treatment may be necessary for patients who develop genital pseudoelephantiasis, a complication seen most commonly in women. In these cases, ulcers or scar tissue obstruct lymph drainage and lead to severe localized edema.

Epidemiologytoggle arrow icon


Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon


Clinical featurestoggle arrow icon

Granuloma inguinale (Klebsiella granulomatis) should not be mistaken for lymphogranuloma inguinale (Chlamydia trachomatis serotype L1–L3), which is commonly known as lymphogranuloma venereum!


Diagnosticstoggle arrow icon

Granuloma inguinale is a clinical diagnosis supported by the presence of Donovan bodies in smears from the lesion.


Differential diagnosestoggle arrow icon

The differential diagnoses listed here are not exhaustive.

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Complicationstoggle arrow icon


We list the most important complications. The selection is not exhaustive.

Referencestoggle arrow icon

  1. Kumar V, Abbas AK, Aster JC. Robbins & Cotran Pathologic Basis of Disease. Elsevier Saunders ; 2015
  2. Satter EK. Granuloma Inguinale (Donovanosis). Granuloma Inguinale (Donovanosis). New York, NY: WebMD. Updated: January 23, 2017. Accessed: March 25, 2017.
  3. Velho PENF, Souza EM de, Belda Junior W. Donovanosis. Braz J Infect Dis. 2008; 12 (6).doi: 10.1590/s1413-86702008000600015 . | Open in Read by QxMD
  4. Le T, Bhushan V, Bagga HS. First Aid for the USMLE Step 2 CK. McGraw-Hill Medical ; 2009
  5. O’Farrell N, Moi H. 2016 European guideline on donovanosis. Int J STD AIDS. 2016; 27 (8): p.605-607.doi: 10.1177/0956462416633626 . | Open in Read by QxMD

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